Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier QX Low / Median / High Price $1,202.26 / $1,202.26 / $3,162.28	Facility	QX	$1,202.26	$1,202.26	$3,162.28
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $616.60 / $1,096.48 / $1,698.24	Professional	AA	$616.60	$1,096.48	$1,698.24
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $489.78 / $645.65 / $891.25	Professional	QZ	$489.78	$645.65	$891.25
Ambetter Facility/Professional Professional Modifier AA Low / Median / High Price $138.04 / $199.53 / $524.81	Professional	AA	$138.04	$199.53	$524.81
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $158.49 / $295.12 / $891.25	Professional	QZ	$158.49	$295.12	$891.25
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QK	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QX	$52.48	$52.48	$52.48
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $52.48 / $52.48 / $52.48	Facility	QY	$52.48	$52.48	$52.48